Number of nurse practitioners more than doubles, study finds

The population of nurse practitioners (NPs) more than doubled from 91,000 to 190,000 between 2010 and 2017 across the country due to the rapid expansion of education programs, according to a new study appearing in the February issue of Health Affairs.

The study found that during this time more NPs entered the workforce than physicians, despite the fact that there were ten times more physicians than NPs in 2010. The largest growth was seen in outpatient clinics, which have become key places for healthcare delivery. The south central region of the country saw the largest increase, though it was unclear if this was due to a difference in demand for NPs, the supply of new graduates, scope-of-practice laws, or other factors.

It also found that this increase coincides with a change in NP education, specifically that more programs are offering distance learning and online education formats, compared to the in-person lectures and extensive hands-on clinical training which was prevalent when the baby boomer generation was studying to become NPs.

This increase can have bold implications for the healthcare industry, the most obvious being an increase in the amount of care provided by NPs. During the same time period, the Medicare Payment Advisory Commission reported an increase in the share of all Medicare evaluation and management office visits billed by NPs and physician assistants rose from 4.6 percent to 12.3 percent, the study says.

The study does caution that it is possible that the increases in the NP workforce might outpace demand and cites the Health Resources and Services Administration’s projection of a 62 percent surplus of primary care NPs by 2025. But also cautions that the administration’s projection failure to fully account for the overlapping roles of primary care physicians and NPs, which indicates that the increase in NPs can handle issues caused by an aging population and scarcity of primary care physicians.

During this period NP inflation-adjusted earning have increased by 5.5 percent while unemployment remained very low, which are two signifiers the authors see as boding well for the current market of NPs. A decline in earnings and rising unemployment would signal an over-saturation.